Healthcare Provider Details

I. General information

NPI: 1407794670
Provider Name (Legal Business Name): SELESS PAULINE CHARITY BARNES FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 30TH ST FL 4
OAKLAND CA
94609-3302
US

IV. Provider business mailing address

PO BOX 5494
HERCULES CA
94547-5494
US

V. Phone/Fax

Practice location:
  • Phone: 510-879-9200
  • Fax:
Mailing address:
  • Phone: 510-879-9200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberF02260349
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: